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Army achievers

March 27, 2007 -- National press stories this month have highlighted the key role that nurse leaders can play in the U.S. Army's health care system. Today, National Public Radio ran a "Leading Ladies" profile, "Clara Adams-Ender: Army Achiever." The main feature is Cheryl Corley's positive 12-minute interview with retired General Adams-Ender, who headed the Army Nurse Corps from 1987-1991. Gen. Adams-Ender discusses her career and relevant issues, including the recently reported problems at Walter Reed Medical Center, where she once ran the department of nursing. Another nurse leader emerged in The Washington Post 's mid-March reports about Walter Reed. General Gale Pollock was appointed acting surgeon general of the Army--the first non-physician to hold that post--after Gen. Kevin Kiley resigned in the wake of criticism over his handling of conditions at Walter Reed. Gen. Pollock seemed to get off to a bit of a rocky start after the Post 's disclosure of an e-mail she sent to military colleagues railing about "media assaults." But she quickly gave the paper an interview in which she came off as more conciliatory and committed to resolving problems. None of the stories we saw said much about nursing, though the NPR piece would have been a great vehicle to do so. Gen. Adams-Ender apparently established the first neonatal ICU in Germany, though NPR fails to mention it. But both sets of stories do show the public that nurses can lead at the highest levels.

General Clara Adams-Ender

The NPR interview with Gen. Adams-Ender (above) was the last of a series in which the radio network's "News and Notes" profiled "distinguished women in leadership." Cheryl Corley's interview was the main feature, though the NPR site also included brief introductory text, photos, and online-only audio clips. Corley leads the engaging, articulate Adams-Ender through a friendly conversation about her personal background and her long military career, including discussions of leadership, gender, race, and military issues, including Walter Reed. Adams-Ender's comments on this last topic are are diplomatic, but not so different from Pollock's email in their overall theme--she says serious problems must be fixed, but emphasizes that the problems did not relate to care of those whose condition was most critical, and seems to suggest that the media did not give a balanced look at the generally fine care given at Walter Reed.

It is disappointing that this extensive and very positive look at Adams-Enders's career included little about nursing itself. We do learn that the General served as head of the Army Nurse Corps from 1987-1991, and that she ran the department of nursing at Walter Reed. But we learn nothing about what those jobs actually entailed, about the importance of nursing in the military, or how it might differ from civilian nursing. The NPR site's print introduction notes that Adams-Ender received an "undergraduate degree in nursing," and that she became a "teacher" who "would train a generation of Army nurses." But the interview ignores that, and we hear nothing about Adams-Enders's advanced training or other achievements in nursing. In fact, she has a masters in nursing and is a Fellow of the American Academy of Nursing. She is known for spearheading key advances in critical care nursing in the Army, and she reportedly established the first neonatal ICU in Germany. Corley does observe that nursing was one of the paths open to women in the military when Adams-Ender enlisted in 1959, whereas almost everything is open to women now. But rather than pursue what that key change might mean for military nursing (or nursing generally, since the larger society experienced the same shift), Corley wants to know what Adams-Ender thinks of women in combat. Nursing itself does not seem to be of interest.

General Gale Pollock

General Gale Pollock's appearance in mid-March stories in The Washington Post was, of course, a far less friendly affair. A March 13 story, Josh White's "Surgeon General of Army Steps Down," reports that General Kiley agreed to resign "after weeks of public criticism" of his handling of the problems at Walter Reed, which related to living conditions and bureaucracy. The piece notes that Gen. Pollack, Kiley's current deputy, will serve as acting surgeon general until an advisory board recommends a permanent replacement. Then the piece moves into an extended discussion of the email Gen. Pollock sent to staff at the Army Medical Command that was "obtained by" the Post. The email reportedly "sought to minimize reports about conditions at Walter Reed and attacked the media's handling of the issue." The Post quotes Pollack as writing: "I know everyone is extremely pained and angry about the media assaults on Walter Reed and our senior leaders." The Post says Pollock pointed out "'our displeasure at the misinformation about the quality of care' to a Post reporter after a congressional hearing last week but also acknowledged that she believes the stories could create momentum for changes that would better serve the Army." Pollock's email reportedly urges staff to reassure their families "that the media makes money on negative stories not by articulating the positive in life -- though that is something I will never understand." Pollack's spokeswoman makes an effort at damage control, noting that the email was "intended to lift the spirits and reinforce confidence in her colleagues and her staff." After more discussion of Kiley and Congressional reaction, the piece gives Pollack the last paragraph:

A certified registered nurse anesthetist who has 30 years of service in the Army, Pollock also has an MBA from Boston University and a master's degree in health-care administration from Baylor University. Before moving to Kiley's office in October, Pollock most recently commanded Tripler Army Medical Center in Hawaii.

This paragraph--unlike the 12-minute NPR interview about Adams-Enders's career--at least gives readers a sense of Pollock's nursing specialty and her advanced education.

One day later, on March 14, the Post followed up with Steve Vogel and Josh White's "Soldiers Detail Walter Reed Problems: Review Board Hears Testimony on Patient Treatment at Hospital." Though the article is mainly about a Pentagon hearing, at the end it tacks on some "meanwhile" follow-up reporting about Gen. Pollock. This piece finds Pollock making an effort to change the impression created by her apparently leaked email. She gives the Post her first interview since assuming the acting surgeon general of the army position, and the paper notes that she is "the first non-physician to hold the surgeon general position." The paper also reports that she says she is "committed to fixing the problems" in the Army's health care system in a transparent way, and that her priorities will be the most obvious issues, like the physical infrastructure at Walter Reed. She also says she is "assembling teams" to work on the problems, and "will emphasize caring for the wounded" while working to reduce bureaucracy. As for the email:

Pollock said she sent a strongly worded e-mail to her subordinates on Friday that assailed media reporting at Walter Reed largely to lift spirits and encourage people to put the reports in perspective. She said that the public scrutiny of the Army's medical department could lead to massively important changes, bringing light to interagency problems that before were almost impossible to tackle, but that she also wants those in the medical community to understand that their missions are vital and that they are appreciated.

Despite this forward-looking tone, Pollock reportedly says that losing Kiley and Gen. George W. Weightman, who lost his command at Walter Reed, was a "huge blow to Army medicine":

General Kiley...wanted to remove himself as an obstacle to our forward progress. ... It's very, very sad that because we can't be perfect, we're not allowed to contribute what we have the potential to contribute.

Perhaps this last statement was not really directed at the public, but it suggests that Pollock views Kiley's departure as an example of someone being forced to resign for arbitrary reasons, as if the problems at Walter Reed really just amount to a failure to "be perfect"--nothing serious. In any case, despite these controversial issues, the Post reports do present Pollock as a player in military health, as someone with real authority grappling with vital issues.

We thank NPR and the Washington Post for their efforts to tell the public something about these important military nurse leaders.


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